Showing posts with label Healthcare. Show all posts
Showing posts with label Healthcare. Show all posts

Sunday, 1 July 2007

The Blair Effect

The year was 1997 - Tony Blair had just won a historic general election and become Prime Minister. There were crowds of people cheering as he went down Downing Street. The following are extracts from his victory speech on May 2nd of that year:
"And this new Labour government will govern in the interests of all our people — the whole of this nation. That I can promise you. When I became leader of the Labour party some three years ago I set a series of objectives. By and large I believe we have achieved them. Today we have set objectives for new Labour Government - a world class education system. Education is not the privilege of the few but the right of the many.

A new Labour Government that remembers that it was a previous Labour Government that formed and fashioned the welfare state and the National Health Service. It was our proudest creation. It shall be our job and our duty now to modernize it for a modern world, and that we will also do."
and...
"And it will be a government that seeks to restore trust in politics in this country. That cleans it up, that decentralizes it, that gives people hope once again that politics is and always should be about the service of the public. And it shall be a government, too, that gives this country strength and confidence in leadership both at home and abroad, particularly in respect of Europe."
There were plenty of promises and 10 years of leadership should be time for those promises to be delivered. The list of achievements below is taken from the Keeping the Faith website, which is dedicated to supporting Tony Blair (or was):
  • Britain now has the lowest inflation for thirty years and the lowest mortgage rates for forty years - saving homeowners an average of £3,700 a year compared to the Tory years. We have the longest period of sustained growth for 200 years.
  • The number of people in work is at a record level, up by over 2 million since 1997.
  • Over 1.5 million working people are better off thanks to the National Minimum Wage.
  • Hospital waiting lists in England are at their lowest since 1987.
  • In the NHS there are 19,300 more doctors and over 77,500 more nurses working with modern equipment, giving faster access to more people, all free at the point of need.
  • Standards are up across the board including the best ever primary school results. More teachers are in our schools than at any point in last 20 years - 28,500 more than in 1997.
  • Police numbers are at record levels - up over 12,500 since 1997, and are assisted by over 4,000 new Community Support Officers.
Seven achievments in 10 years. Wow - that's impressive (you might note a tiny bit of sarcasm there).

Let's think about the point about employment 2 million more people in work is absolutely brilliant. Well, it is brilliant until you find out that Britain is capable of increasing it's population by 1,420,306 in four years. That 'achievement' assumes that the population is static for 10 years.

Another interesting thing is that 'full employment' is frequently mentioned in New Labour propaganda (for instance, Gordon Brown mentioned it in this speech back in 2005). Full employment is - and always has been - impossible. There's always going to be a certain amount of people who spend a few days or week 'between jobs'. This could be due to resignations, redundancies and all sorts of other things.

The point about the NHS is interesting. It mentions how many doctors and nurses that have been recruited since 1997 (a combined total of 96,800), but it doesn't mention how many doctors and nurses have left since '97. According to this article, 20000 nurses have left the NHS (not sure whether this is since '97 or later than that), in 2006 3000 nurses went to work in Australia and there'll be a nursing shortfall of 14000 by 2010. That makes the recruitment figures less than impressive as it means there could either be a smaller overall gain or even a loss.

After Gordon Brown became Prime Minister, Patricia Hewitt lost her job as Health Secretary:
"She was widely expected to lose her post after increasing pressure over NHS deficits and doctor training schemes."
That doesn't sound particularly good, does it? This article states that a study reveals that only 34% of the country believe that the Labour government had made the NHS better (this study was done by the British Medical Association, so it's a reputable source). Is that good? I don't think so. It's also interesting to note that the 2005 general election exit poll showed 37% of the vote was Labour (although this is made slightly less relevant by the fact that the turnout was 61.3%). That might account for some of the percentage at least.

Now for education. This was one of the things Blair and the New Labour regime focused on the most (at least initially). As well as the point in that achievements list, they often mention the City Academies, the 50% target for Higher Education and lifelong learning.

On the subject of Academies, this is how they're defined:
"Academies are all ability schools established by sponsors from business, faith or voluntary groups working in highly innovative partnerships with central Government and local education partners. The Department for Education and Skills (DfES) meet the capital and running cost for the Academy in full."
Tony Blair has said that parents back the scheme and Gordon Brown intends to continue with the plans under his regime, but people such as Estelle Morris (former Education Secretary and now a university Pro-Vice Chancellor) has her reservations. The academies scheme has also been criticised by the Education and Skills Select Committee and the Liberal Democrats.

The 50% target for universities is ridiculous. What about people who don't want to go down the academic route and want a more vocational style of education? What about the people who don't need that level of education for the job that they want to do? If the cap is to be taken off fees, then less people will be able to afford that level of education - which means the target will never be reached. For those who get to uni, it will mean that they'll have to take on even more part-time work, which will increase their stress levels and affect their academic performance. Sure, I think unis needed more money to improve resources for the increasing numbers, but I don't think the cap should be removed.

Lifelong learning has been a success. More and more mature students are coming to universities now to seek a higher level of education for a variety of reasons. However, if the cap were to be lifted - what would happen to them? A lot of mature students have extra responsibilities such as children and a lot of their money goes towards caring for them. How could lifting the cap make it easier for them to get into HE?

I won't cover this much more though, as I have an educational blog to go into more detail about this. I won't go into detail about the 'war on terror' either - as I have made it clear in a previous post on this blog that I strongly oppose it.

Lets not forget that Blair and Labour have done some good things during the past 10 years. They helped to secure the 2012 Olympic Games and....erm...help me out here!

Now we hear that Blair has become a Middle East Peace Envoy. I'm not quite sure why anyone could see him being effective in that role. Alongside George Bush, he went to war in Iraq and has stood alongside Bush in his opposition to any nuclear weapons programme in Iran (as I stated in a previous blog post, they have no proof of that programme yet).

There are plenty of other things I could comment on, such as the failing immigration system, the failed ASBO system, The New Deal or the fact the for years we have had a Deputy Prime Minister (John Prescott) who has done very little apart from go on junkets, have scandalous affairs and speak completely incoherently, but I won't as I'd be here forever.

So, what do you think?

Technorati tags: Government, War, Healthcare, Education, Democracy, Tony Blair

Saturday, 3 March 2007

The ambulance IT system

I read this article and was shocked.
"Urgent talks are underway to save a computerised capacity and activity monitoring system (CAMS) used to direct ambulances to hospitals best placed to deal with patients after PCTs in the East of England SHA withdrew their funding.

The East Anglian Ambulance Trust and acute trusts across Norfolk, Suffolk and Cambridgeshire are in last minute talks with East of England (EoE) SHA to prevent the screens going blank on 7 March 2007."
Instead of just withdrawing the funding (£175,000 per year), why can't the PCTs actively find ways to make it financially worthwhile. There are clear technical and productivity benefits - so it would definitely be worth saving.

Apparently there has been a massive overspend of £175m. What happened to proper financial planning and project management? I learned that sort of thing at A-Level and this is a government project - so they should know this stuff. It's just plain ridiculous.

Nurses update the system's information on a two-hourly basis and it contains details of the number of empty beds and waiting times. That sort of thing can be essential as there are many cases where patients need to get to hospitals as soon as possible and if they arrive at one that's full, they could die.

Recent evaluations of the system show that it can save a lot of money and it tends to divert around 5% of patients. That might not seem much, but when you consider the number of busy A&Es across the country, it can add up to quite a few people.

The reporter for E-Health Insider mentioned:
"Losing CAMS is unlikely to endanger patients, sources told EHI, as hospitals have a duty to treat patients in an emergency. But it will mean the ambulances and trusts revert to pen and paper."
Considering that the NHS is implementing the National Programme for IT, which supposedly revolutionises the way hospitals work, this goes against the objectives of the government project.

In the FrontPoint Systems blog, they call it "short-termism" in this entry. It's certainly that. There have been many cases where businesses have initially made losses, but then gone on to make a profit. Why can't the PCTs see that the savings will eventually cancel out the epxense (ok, it might be a long time given the overspend, but it will happen eventually).

The key objectives in the strategic action plan for the Welsh version of this system are:
  • Provide and coordinate an increasing range of mobile healthcare for patients who need urgent or unscheduled care
  • Provide an increasing range of other services and alternative care pathways, e.g. in primary care, diagnostics and health promotion
  • Improve the speed and quality of service provided to patients with emergency care needs
  • Improve the speed and quality of call handling, provide significantly more clinical advice to callers, and work in a more integrated way with partner organisations to ensure consistent telephone services for patients who need urgent care
  • Improve overall efficiency, effectiveness, consistency and quality of care provision
  • Ensure Trust compliance with the Civil Contingencies Act 2004
  • Provide strong leadership, both clinical and managerial, so that organisation structure, culture and style match new models of care
Those objectives will be the same as the English version, and they are worthwhile objectives. Why not do something to keep the system going?

So, what do you think?

Technorati tags: Ambulances, IT, Healthcare